Friday, March 20, 2015

Censorship at the British Stammering Association Facebook page

Wow, I have just witnessed censorship on the British Stammering Association Facebook page. I saw this post and suddenly it was gone. Interestingly, Norbert Liekfeldt has blocked me as a Facebook friend for my Facebook posts. Norbert has a problem accepting other people's views if they clash with his own ideology. Especially when they are politically incorrect according to him.

As you know, I am for full transparency and open debate. That's why I will post the screenshot here. Things need to be discussed (even if politically not correct) not suppressed! This has been a major disease of the last decade in the UK.


Wednesday, March 18, 2015

A very important question to Onslow and Packman

Onslow and Packman write in a response to the controversy of Lidcombe becoming the state-sanctioned treatment of choice:
"Indeed, if such evidence emerges for the efficacy of another treatment for early stuttering, we would encourage Speech Pathology Australia to approach the Australian government to consider it also for taxpayer-assisted support."
Here is the key question to them:

The Franken study has shown that there is no difference in efficacy between Lidcombe and a second treatment approach Demands And Capacities. So I ask:

As Lidcombe is effective (according to you) and the Franken study shows a similar efficacy for Demands & Capacities, does that constitute enough evidence to use Demands & Capacities in Australia too?

Deborah Theodoros has been misinformed about the efficacy of Lidcombe

The Australian Speech and Language Association's president Deborah Theodoros seems to be badly misinformed about the efficacy of Lidcombe as she wrote in her statement on Graig Coleman's concern about making Lidcombe the treatment of choice in Australia:
"early stuttering intervention at a level which is demonstrated to be highly efficacious and supported by the strongest level of evidence."
As I understand she is not an expert in stuttering so someone must have whispered in her ear and she refused, so far, to lend her other ear to an opposing opinion. Her statement is completely overblown. (check also my first response to the debate)

Let's deconstruct her statement: "demonstrated to be highly efficacious:"

This is simply not the case if you look at the long-term data and if you know, like me, the many cases clinicians tell me about where it did not work. Even Onslow, Packman, et al's recognize that
At the time of this follow-up, the children were aged 7-12 years, with a mean of 5 years post-randomization in the 2005 trial. Twenty of the 29 children in the treatment arm and eight of the 25 children in the control (no treatment) arm were able to be contacted. Of the children in the treatment group, one (5%) failed to complete treatment and 19 had completed treatment successfully and had zero or near-zero frequency of stuttering. Three of the children (16%) who had completed treatment successfully had relapsed after 2 or more years of speech that was below 1% syllables stuttered. Meaningful comparison with the control group was not possible because an insufficient number of control children were located and some of them received treatment after completing the trial.
To conclude, the treatment was not "highly efficacious" at all, especially if you compare it to the natural recovery rate of 70%-80%. And due to the small number of 29 children, the statistics are bad. And there was no control group to control for natural recovery, so you cannot actually judge the relative performance to a non-treated group.

The statement "supported by the strongest level of evidence." is, as you can see, completely overblown.

Deborah Theodoros should seek independent counsel on this matter to counter the notion that her statement and her association projects a certain carelessness regarding dissenting opinion. She cannot just hear the arguments of those that have worked hard to create and establish, and then also measure the treatment; a clear conflict of interest. All in good intention but nevertheless Lidcombe is neither "highly efficacious" nor supported by "the strongest level of evidence."

Friday, March 13, 2015

Lidcombe the only effective treatment in Australia?


US cultural imperialism, this time for good reasons, has struck Australia. The Australian government and speech and language association has plans to make Lidcombe the unique treatment option available for clinicians to treat stuttering kids, because it is the most studied and has been proven effective. As we all know, this campaign is very likely led by Prof Onslow and his people. He is very much Mr Stuttering in Australia, and sucks up most of the research funding and probably sits on the research council board to decide on other people's funding. He was also so kind to send me a nice letter from his university's lawyer a few years ago, and was very eager to have a few nice chats with the director of a Dutch researcher who wanted to compare Lidcombe with another treatment option - an episode that she has still not spoken publicly about. I wonder what would happen if she were to write an open-ed in a main Australian newspaper about this episode?

So as you see, we again need the Americans to police the world! Soft power of course. Australia deserves an opinion that opposes the opinion of the lords of the lands down under. A petition by Craig Coleman does exactly this:
Recently, Speech Pathology Australia (the national speech-language pathology association of Australia) submitted a proposal to the Australian Government Department of Treasury that would require Medicare rebates be made available for children who stutter, but only if they are treated using the Lidcombe Program. 
The ramifications for this action are significant. As expected, many speech-language pathologists from the U.S. and abroad do not support this action for several reasons. First, this action gravely limits the scope of treatment for stuttering. Many interventions for preschool stuttering have shown to be effective (Millard, Nicholas, & Cook, 2008; Yaruss, Coleman, & Hammer, 2006; Franken, Kielstra-Van der Schalk, & Boelens, 2005).
So what is my opinion?

Tuesday, March 10, 2015

To those obsessed by p-values

I have always looked with horror at the near religious and blind application of p-values in hundreds of stuttering research papers.

Here is a blog post discussing p-values:
The journal Basic and Applied Social Psychology has come out with a ban on p-values. To be precise, they've banned the “null hypothesis significance testing procedure” from articles published in the journal. This ban means that authors in the journal can’t claim that an effect they see in their data is “statistically significant” in the usual way that we’re all accustomed to reading.

Thursday, January 29, 2015

Australian study screens baby's brains

Here is a report on an Australian research study which screens baby's brains. Those babies have stuttering siblings, which make them more likely to develop stuttering. How successful is this study going to be?

As always in Australia, Mark Onslow is involved. He was probably the person who worked hard to get the money and the people together, something he is good at. The outcome of his studies is not always so good unfortunately. First, the outcome study of Lidcombe early childhood intervention was problematic and a review a few years later was unable to locate all the kids who actually had taken part in the treatment. Second, there was a long-term study on stuttering on a large scale, but I haven't heard of the results at age 5, for example, even though the study should have those data. Long-term studies are always sensitive to many factors, e.g. people leaving, money running out, people using interests.

Tuesday, December 23, 2014

Lidcombe is dead: long live any treatment?

It took Peter years to get Marie-Christine Franken on StutterTalk. So enjoy the podcast! And it took her years to have the 2007 comparative study between Lidcombe and Demands&Capacities analysed and published: a true source of frustration to me as this is such a key piece of research to dispel claims of supremacy by Lidcombe. Already in 2012, they had the data but it took more than 2 years to write it up and get it published.

The listener will note that Marie-Christen is a bit scared of misspeaking and of her findings... She might be an overly cautious person by nature, but if a friend of a friend told you that she actually got bullied from someone in a distant land and was concerned about her job security, you can understand why she behaves the way she behaves.

The key statements are
  • The large-scale study started in 2007 did not find a significant overall difference between the two treatment approaches: Lidcombe and Demand and Capacities treatment.
  • She expects the study to be published within months.
  • She refutes that it is only ethical to use Lidcombe.

Wednesday, October 29, 2014

How the tower of information leads to an integrated framework for biopsychosocial ideas

I have published an article with a friend of mine on a new framework on how to classify all drivers of human behaviour and experience. I have specifically designed it to include all possible drivers of stuttering behaviour in one single framework, and it turned out to be generic to all behaviour and disorders. More details on our website bps2.com.

Here is the abstract:
The biopsychosocial model is the prevailing conceptual model in relationship to which clinicians organize their analysis, evaluation and intervention. Since its promotion by Engel, little work has been done to provide a more solid conceptual basis for the relationship between the biological and the psychosocial processes in sickness and in health. We propose such a framework, using the perspective of life forms as information gathering and utilizing systems. We derive the simplest non-trivial model, the four domain model, which consists of the physical domains determining human processes: the environment, the body, the confined memories, and the communicable memories. We then re-visit Engel's case study to contrast our model with his systems approach, and apply it to issues in psychosomatics and the mind-body connection.
If you want a complimentary copy, please send me an email: tom dot weidig at gmail dot com


Tuesday, August 26, 2014

Check out and support Dylan's work!


My name is Dylan Madeley, and I've struggled to come to terms with two different aspects of my life. The first one set me on a path of frustration and retrying, constant self-improvement, bouts of social isolation, and has ultimately played a huge role in defining who I am today. The second one is stuttering, which I've lived with since about age five. In both cases, I spent some time running away in one form or another; in both cases, I have felt more whole as a person by accepting them and being more open about them. I live in a suburb north of Toronto with two chinchillas, write and copy edit for Auxiliary Magazine, and in my spare time pursue a career as a novelist. I have written one manuscript of minimum 50,000 words each year since 2008.

Since this blog has a stuttering/cluttering focus, I'll share my views about how these two things relate to each other. I took up creative writing a few years after developing a stutter, and my dad inspired me to tell stories. While I can't reach into my thought processes at the time, I strongly suspect that here I was with very real and seemingly insurmountable communication difficulties, immediately setting me apart from every other kid I knew (for years, the only other two stutterers I had ever met were two guys who also attended Sick Kids for speech therapy). The written word has its own challenges, vast and not perfectly understood by me at a